Skull base non-Hodgkin’s lymphoma

Abstract

Primary skull base lymphoma accounts for 1% - 2% of all skull base tumours. It is a very rare condition, which poses a diagnostic challenge in clinical practice but needs early diagnosis and treatment. We present a case of primary lymphoma of the skull base in a 53-year-old woman, who was admitted with complaints of bilateral temporal pain, facial numbness, slurred speech, difficulty in swallowing and deafness. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) showed ill-defined destruction of the petrous temporal bone with a high signal area noted on T2 weighted images in the right temporal lobe which initially was thought to be skull base osteomyelitis. However, a finding of a thin subperiosteal dense soft tissue in the left parieto-occipital region with intact adjacent bone cortex similar in appearance to the of the primary skull base pathology was seen which alerted the team to possible diagnosis of skull base lymphoma.